The Effects Of Extracorporeal Shock Wave Therapy On Triceps Surae Spasticity And Gait In Hemiplegic Patients

BackgroundSpastic triceps surae and abnormal gait pattern severely affect patients’ daily life after stroke.Timely assessment and correction of abnormal gait pattern and reduction of triceps surae spasticity are particularly important for the patients of stroke with hemiplegia.The Myoton muscle tension measuring instrument is a small,portable,safe,non-invasive and highly sensitive muscle testing device that can quantitatively observe small changes in the degree of spasticity after extracorporeal shock wave therapy.The commonly used indexes are Oscillation Frequency(F),which can be used to quantify the magnitude of limb muscle tone,and Dynamic Stiffness(S),which can be used to quantify the magnitude of limb muscle stiffness.There are few studies on the effects of extracorporeal shock wave therapy on walking ability after stroke.In this study,we observed changes in tone and stiffness of tricepssurae,lower limb motor function,and spatiotemporal parameters and asymmetry parameters of gait by performing radial extracorporeal shock wave therapy on the triceps surae of patients with spastic hemiplegia.MethodsSixty-two patients with hemiplegia who met the inclusion criteria were randomly divided into a study group and a control group,with 31 patients in each group.The study group was given standard rehabilitation plan and radial extracorporeal shock wave therapy(r ESWT),three times a week for four weeks.The control group was given standard rehabilitation plan and the placebo r ESWT.Modified Ashworth Scale(MAS),the lower extremity part of Fugl-Meyer Assessment(FMA),ankle dorsi-flexion passive range of motion(PROM),the Myoton muscle tension measuring instrument,and a three-dimensional gait analysis instrument were used before and after the treatment to observe the effects of extracorporeal shock wave therapy on gait parameters and triceps surae spasticity in hemiplegic stroke patients.ResultsAfter treatment,the MAS scores,Oscillation Frequency(F)and Dynamic Stiffness(S)significantly decreased,and ankle dorsi-flexion PROM and the lower extremity part of FMA scores significantly increased in both groups compared with those before treatment,and the improvement of each parameter in the study group was more obvious and significant than those in the control group(P< 0.05).The spatiotemporal parameters and asymmetry parameters(the ratio of paretic to non-paretic swing phase)of gait in both groups were significantly better compared with those before treatment,and the walking velocity,stride lengthand the non-paretic swing phase time were significantly increased in the study group than those in control group(P<0.05),non-paretic stance phase time,double stance phase time and foot length deviation were significantly decreased in the study group than those in control group(P<0.05).ConclusionExtracorporeal shock wave therapy combined with routine rehabilitation training can effectively reduce muscle tone and stiffness of the triceps surae in stroke patients,improve the motor function of the lower limb,and improve gait parameters to improve walking ability.